Administering Medication by Intermittent Infusion (Piggyback Set)

Administering Medication by Intermittent Infusion (Piggyback Set)

Equipment
■ Correct-size syringe for measuring medication.
■ Needleless access cannula or safety needle.
■ Small bag of diluted medication with piggyback tubing.
■ Primary IV solution and tubing (unless one is already infusing).
■ Antimicrobial swabs.
■ Labels for the IV tubing and medication administration system.

Assessment
■ Check the site for redness, swelling, tenderness, and other signs of infiltration or phlebitis. Post-Procedure Reassessment
■ Assess for complaints of pain or discomfort at the site.
■ Be Smart! Intermittent infusions are generally administered over 15 to 60 minutes, so you need to assess the patient as soon as the infusion begins and every 15 to 20 minutes until it is absorbed.
■ Assess for factors that will provide a basis for evaluating the drug’s effectiveness, such as checking BP after administering an antihypertensive agent.

Key Points
■ Be Safe! Ensure the compatibility of the IV solution and medication, in both the primary and secondary (piggyback) systems.
■ Be Smart! Be sure you have the correct tubing. Piggyback tubing is short; tandem tubing is long.
■ Be Smart! Calculate the amount of medication to add to the solution. Use the correct amount and type of diluent solution.
■ Be Safe! Use the correct rate of administration.
■ Be sure the slide clamp is closed. Squeeze the drip chamber, filling it one-third to one-half full.
■ Open the clamp and prime the tubing, holding the end of the tubing lower than the bag of fluid.
■ Be Safe! Affix the correct label to the piggyback bag, identifying the infusate, patient name, start date and hour, discard date and hour, and your initials.
■ Hang the piggyback container on the IV pole. Lower the primary IV container to hang below the level of the piggyback IV.
■ Open the clamp of the piggyback line and regulate to the prescribed infusion rate for the medication.
■ At the end of the infusion, clamp the piggyback tubing, and reset the primary bag to its correct infusion rate.

Documentation
■ Record the appearance of the IV site and patient complaints of pain or discomfort during IV administration.
■ You will usually document on an IV flow record and/or MAR rather than in the nursing notes.
■ Chart a nursing note only if there is a problem (e.g., if the patient experiences pain when you administer the medication).

Piggyback administration set